Official defends County Harbor-UCLA Medical Center after incidents

Los Angeles County's health services director said Tuesday that he was concerned about recent patient care problems at County Harbor-UCLA Medical Center, but believes the hospital is working to prevent such incidents from happening again.

"When mistakes happen, we are accountable and immediately work to correct the processes that enabled them," said the director, Dr. Mitchell Katz, in a statement responding to an article in the Daily Breeze. "The two cases cited in the article are troubling and not indicative of the medical care received by tens of thousands of individuals who seek care each year at Harbor-UCLA."

The Daily Breeze reported Sunday that a psychiatric patient died and a surgical patient was injured amid mistakes last summer at the county-run trauma center near Torrance.

The news has stirred concern among community leaders about the quality of care at Harbor-UCLA, the only Level I trauma center south of the Santa Monica Freeway and a key safety net hospital for the county's low-income and uninsured patients.

Katz, who became director of health services in January 2011, said he regretted any harm caused to patients at county-run hospitals overseen by his department.

"A hospital should be a place of safe refuge and healing, not harm," Katz said.

County Supervisor Mark Ridley-Thomas, whose district includes Harbor-UCLA, expressed confidence in Katz and in the hospital's new chief executive officer, Delvecchio Finley.

"There's new leadership at that hospital, and it is very focused on making sure that patient care is at its highest possible level," Ridley-Thomas said Tuesday.

Harbor-UCLA's medical chief of staff, Dr. Janine Vintch, released a statement praising the quality and dedication of the hospital's staff.

"These two cases, while tragic, are not representative of all care at the hospital as the article painted," Vintch said. She said the article oversimplified the challenge of caring for psychiatric patients. "Periodically, we have a bad outcome as all hospitals do. It is a part of the job that makes being a physician so difficult."

But some expressed worry that recent problems at Harbor-UCLA signal that the county hospital system is too large and complex to be managed by the county Board of Supervisors.

"This is about life-and-death situations. When are they going to understand that they need a different type of governance?" said Lark Galloway-Gilliam, executive director of Los Angeles-based Community Health Councils, a health policy and advocacy group for low-income and uninsured residents.

The death of the psychiatric patient, who refused food and water for 16 days, was among patient care problems that were chronicled in a Medicare report following a Sept. 13, 2011, inspection of the hospital. The report, which had not been publicized, was obtained by the Breeze in March under the federal Freedom of Information Act.

The survey was one of three inspections Medicare conducted at Harbor-UCLA in less than two years. The results prompted the Centers for Medicare and Medicaid Services to threaten to cut off the hospital's Medicare funding. That move could close the hospital.

Harbor-UCLA responded by instituting new policies and making other changes. After a successful Jan. 12 follow-up survey, Medicare sent a March 8 letter to Finley stating that the hospital's Medicare status had been restored.

Following the patient's death, Harbor-UCLA created new guidelines for the treatment of patients who refuse to eat or drink. The policy is now in effect at all hospitals overseen by the Department of Health Services, county staff said.

Harbor-UCLA has also changed its pre-surgery and anesthesiology guidelines after a patient undergoing elective knee replacement surgery last August nearly bled to death. No blood had been typed and cross-matched in advance, delaying a blood transfusion, according to the Sept. 13, 2011, inspection report.

Dr. Judith Kraft, medical director at the close-by Wilmington Community Clinic, said she was puzzled by the newspaper's account of the surgery and thought that typing and matching blood before surgery is routine.

"It was surprising. I felt that there was probably something in place to prevent that. How it got missed, I don't know," she said.

Kraft refers many of her patients to Harbor-UCLA, where, she says, they get the specialty care that many people without insurance could never afford at a private hospital.

"I have a lot of respect for the care given by doctors at Harbor-UCLA. I just feel they're doing an impossible job," Kraft said.

Frances Todd, a Harbor-UCLA pediatric nurse practitioner, said the two incidents last summer do not reflect the quality of care at the hospital.

"They were definitely isolated occurrences," said Todd, who has worked at the medical center for more than 37 years and serves as a union steward there for the Service Employees International Union. The nurses there take yearly competency exams to assure they stay abreast of the latest medical techniques, she said.

"Every hospital has problems," she said. "I think we're one of the best. We have patients who want to come to us that live in the neighborhood who have private insurance."

She was among those who expressed support for Finley and Katz, saying they appear committed to assuring quality care.

"I think they're going to stop problems like this," she said. "They're anxious to hear what we have to say. It's like a new day."

The California HealthCare Foundation Center for Health Reporting is an independent news organization devoted to reporting about health care issues. It is funded by the nonprofit, nonpartisan California HealthCare Foundation.